Nguyen Yvonne, Lee Andrew, Fischer Gayle
Department of Dermatology, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.
Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Australas J Dermatol. 2017 Nov;58(4):e176-e181. doi: 10.1111/ajd.12487. Epub 2016 May 11.
BACKGROUND/OBJECTIVE: Chronic vulvovaginal candidiasis (CVVC) is a disorder characterised by the signs and symptoms of vulvovaginal inflammation and causally associated with the presence of Candida spp. in the vagina. This study aimed to establish the impact of treatment with fluconazole in CVVC on patients' quality of life (QoL).
This was a before and after study conducted in vulval dermatology clinics in Sydney, Australia. Patients were assessed at baseline by the dermatology life quality index (DLQI) and visual analogue scale (VAS) grading of erythema at baseline and at 12 weeks after an oral fluconazole regime. The primary outcome measures were a change in their DLQI score and VAS grading. The secondary outcome measures were its tolerability and adverse events.
A total of 82 of 91 patients (90%) completed the study. The mean drop in their DLQI score was 11.6 [95% CI (10.1, 13.0)] (P < 0.001). The post-treatment VAS scores were significantly lower than the pretreatment scores (P < 0.001). Adverse effects requiring cessation of fluconazole occurred in 4% of patients.
Fluconazole treatment at a dose of 50-100 mg daily achieved a significant observable and improvement in the QoL of 96% of patients with CVVC within 12 weeks of treatment. Adverse effects were minimal.
背景/目的：慢性外阴阴道念珠菌病（CVVC）是一种以外阴阴道炎症的体征和症状为特征，且与阴道内念珠菌属的存在有因果关系的疾病。本研究旨在确定氟康唑治疗CVVC对患者生活质量（QoL）的影响。
这是一项在澳大利亚悉尼的外阴皮肤病诊所进行的前后对照研究。在基线时，通过皮肤病生活质量指数（DLQI）和基线及口服氟康唑治疗12周后红斑的视觉模拟量表（VAS）评分对患者进行评估。主要结局指标是他们的DLQI评分和VAS评分的变化。次要结局指标是其耐受性和不良事件。
91名患者中有82名（90%）完成了研究。他们的DLQI评分平均下降了11.6 [95%置信区间（10.1, 13.0）]（P < 0.001）。治疗后的VAS评分显著低于治疗前评分（P < 0.001）。4%的患者出现了需要停用氟康唑的不良反应。
每日剂量为50 - 100 mg的氟康唑治疗在治疗12周内使96%的CVVC患者的生活质量得到了显著且可观察到的改善。不良反应最小。
